title: Neonatal apnea and gastroesophageal reflux (GER): is there a problem?
abstract: Apnea of prematurity and gastroesophageal reflux (GER) are both common occurrences in preterm infants and widely perceived to be causally related. We seek in this review to provide a potential guideline for neonatal GER non-pharmacologic and pharmacologic therapy. Available physiologic data suggest that when there is a temporal relationship apnea may be more likely to predispose to GER via esophageal sphincter relaxation than vice versa. Measurement of multiple intraluminal impedance via esophageal catheter in addition to esophageal pH has enhanced our understanding of GER, although it also did not demonstrate a causal relationship between apnea and GER. The incidence of GER may be modified by thickening feeds and position change without adverse effects. In contrast, pharmacotherapy including acid suppression therapy may have adverse effects and should only be used in infants with clear evidence of clinical benefit.
authors.affiliation: Division of Neonatology, Rainbow Babies & Children's Hospital, Cleveland, OH, USA.
authors.forename: Elie G
authors.initials: EG
authors.lastname: Abu Jawdeh
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Martin
mesh_terms: D001049:Apnea / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000503:physiopathology; D009126:Muscle Relaxation; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D054328:Proton Pump Inhibitors